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Hypophosphatemic Rickets
Joseph Junewick, MD FACR
over 7 years ago
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Posterolateral corner injury

Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 7 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: CR MRI
Activities:
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History

13 year old male who fell down a sand dune in the Middle East.


Case Images


Diagnosis

Posterolateral corner injury.

Findings

Fracture of the fibular styloid on radiographs. MRI shows avulsion of the fibular styloid by the biceps femoris, medial meniscal tear, partial tear of the PCL, bone contusions/impaction injuries related to hyperextension most evident in the anteromedial femoral condyle.

Discussion

Injuries to the posterolateral corner structures of the knee can cause significant disability due to instability, cartilage degeneration, and cruciate graft failure. The stability of the posterolateral corner of the knee is provided by capsular and noncapsular structures. Injuries to this region can be, but are uncommonly, isolated; usually these injuries are associated with ligamentous injuries elsewhere in the knee.

The mechanism of injury is thought to be most commonly a direct blow to the anteromedial proximal tibia, directed posterolaterally, with the knee near full extension.

Patients with a posterolateral corner injury may present radiographically with an arcuate fracture, segond fracture or avulsion of gerdy tubercle. If any of these findings are identified on radiographs, an MRI should be obtained to evaluate for ligamentous injury which is often associated.

Associated abnormalities to look for on MRI include cruciate ligament tears, bone contusion (particularly anteromedial) and tearing of lateral ligaments (LCL, biceps femoris, popliteus and other smaller ligements such as the arcuate which are not reliably visible)

Reference

MUSCULOSKELETAL IMAGING:
Emily N. Vinson, Nancy M. Major, and Clyde A. Helms
The Posterolateral Corner of the Knee
Am. J. Roentgenol., Feb 2008; 190: 449 – 458.



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